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The murky underbelly of unregulated aesthetics

There is a worrying trend that is on the rise: unregulated and unqualified practitioners providing aesthetics treatments like anti wrinkle injections and dermal fillers. You may have seen news reports and horror stories about people suffering with dangerously bloated lips or drooping eyelids, but the damaging effects can go much further.

There is a worrying trend that is on the rise:  unregulated and unqualified practitioners providing aesthetics treatments like anti wrinkle injections and dermal fillers. You may have seen news reports and horror stories about people suffering with dangerously bloated lips or drooping eyelids, but the damaging effects can go much further.

What can happen if dermal fillers are administered by inexperienced practitioners?

If dermal fillers are administered by people who don’t know what they’re doing, they can inject it into the wrong area, such as an artery, and this could result in blockages leading to necrosis (death) of the tissue, which is irreversible. Incorrectly injected  may have zero effect at all or may cause an uneven face which can last for weeks, or months. There is also a risk of bleeding, infection, or an allergic reaction, which is why it’s so important to choose an experienced practitioner who will be able to deal with these problems.

Is your face worth the risk?

The main draw for clients who succumb to these industry ‘cowboys’ is usually the low cost and the convenience. You’re at a party, having some cocktails, and people are lining up in the kitchen to take advantage of the one-night-only, bulk deal that’s being offered to have their pouts plumped. Of course, you would join in.

But the problem is, like most people, you would probably assume that anyone carrying out invasive procedures like this must be medically qualified and this isn’t necessarily the case. Although anti-wrinkle protein is a prescription-only medicine that can only be prescribed by a healthcare professional with the correct qualification, it is perfectly legal for any member of the public to administer it, regardless of their training, certification or experience. As they can source the (often counterfeited) products online from unofficial sites, they are able to become vending machines for ‘tweakments’ and the consequences of problems and badly considered procedures must be picked up by someone else when it all goes horribly wrong.

That’s not to say they are bad people, or that there are many who don’t try to take a lot more responsibility, but the fact is that they are not technically as responsible, or accountable, though they do take the same risks.

Why should I use a qualified aesthetics practitioner?

Having a qualified healthcare professional, such as a doctor, nurse, dentist or pharmacist perform your aesthetics treatment means that they are governed by a professional body who oversees all their work and any complaints about such.

The central ethos which governs the remit of a healthcare professional is that they SHOULD only ever act to improve the health and well-being of their patient. Decision making and procedure delivery should always be aligned with this objective, and the regulation means they can face sanction if they are proven to not be aligned with this ethos. Other members of the public are free to perform procedures on demand, without considering the impact of their procedures on the recipients physical and mental health in the same way.

Therefore, in my opinion, it’s not necessarily ok for healthcare professionals to support non-healthcare practitioners. We would be supporting a system which is not in alignment with the health of patients. It is against professional values and responsibilities. The key difference is nothing to do with technical capability. 

It’s my opinion that those skills can be taught to any person with a degree of intelligence and manual dexterity. What can’t be taught is the responsibility for the impact on health which healthcare professional must bear legally. I don’t think healthcare professionals can ethically offload that responsibility on unregulated practitioners.  They cannot train or prescribe for them and be consistent with these principles.

What about high street stores?

Something else that is coming up on the radar again is the high-street, big-name stores like Superdrug offering walk-in aesthetics treatments for typically low prices. This is a different situation, as large companies such as this will have procedures to ensure the staff are correctly trained (though not medically qualified, per se).

However, they will not be cheaper than the current cheapest end of the market, no matter what discount they can get from suppliers. And due to the opportunistic nature of the walk-in service, they will only be able to offer the corporate end of the experience. There is no way that they can compete with practitioners who are great at building intimate relationships, so there is room for both of us. They and other corporates have tried several times and failed to get traction so we will see how it works this time! Overall, I take it as another sign of the market growing, less of a threat to the industry than the bottom-end of unregulated practitioners who botch procedures and tarnish all of us.

To get the best aesthetic experience, here’s a few pointers of what to look out for:

For anti-wrinkle injections and dermal fillers, the practitioner should be able to provide a minimum Level 6 certificate from an Ofqual-accredited aesthetics course such as SkinViva or Facethetics :

  • They should be able to provide before and after photos of previous work

  • They should insist on a face-to-face consultation beforehand to assess what is suitable and achievable for you, both physically and mentally

  • They should be a healthcare professional such as doctor, nurse, dentist or prescribing pharmacist

  • Their price point shouldn’t be vastly lower than average, as this may be a sign that they are using counterfeit product

  • Are they a member of Save Face? This is a government-approved, voluntary register of practitioners who have been independently assessed to ensure they hold the correct specialist training and insurance required to practice each procedure safely

  • They should always allow you enough time to consider your treatment without feeling pressured or rushed, and offer a follow up appointment if required

  • They should take and evaluate your relevant medical history and ask you to read and sign a consent form detailing risks, contraindications and aftercare advice

  • And most importantly, TRUST YOUR GUT INSTINCT! If you don’t feel comfortable with the practitioner or the environment then don’t proceed with treatment!

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About the author

Shikha Rishi

Shikha is a highly experienced aesthetics practitioner, pharmacist and medical professional. After training for a number of years at the world-renowned Harley Street, London and SkinViva, Manchester, Shikha is passionate about delivering top-quality results in every treatment.

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